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Uterine Fibroids

Common areas for uterine fibroid growth

Uterine fibroids are growths made of fibrotic cells and other tissue that develop within the wall of the uterus.

Fibroids may grow as a single tumor or in clusters. A single fibroid can be microscopic in size or can grow to eight inches or more across. In many cases, a single uterus can contain many fibroids. Most fibroids range from about the size of a large marble to slightly smaller than a baseball. Bunches or clusters of fibroids are often of different sizes. Not all fibroids grow, and some may shrink, or remain constant over time.

Health care providers categorize fibroids based on where in the uterine wall they grow:

Some fibroids grow on stalks that grow out from the surface of the uterus or into the cavity of the uterus. These are called pedunculated fibroids.

Symptoms

Many women may have no symptoms of fibroids. Though for others, uterine fibroids can cause uncomfortable or sometimes painful symptoms, such as:

Estimates suggest that over 70% of women may have fibroids in their lifetimes, and hundreds of thousands of women seek treatment for fibroids each year. About 200,000 women each year choose to have surgery to treat fibroids by removing their uterus.

Risk Factors

Fibroids usually grow in women of childbearing age. In women 25 to 44 years old, about 30% have symptoms of fibroids.

Several factors affect a woman's risk for having uterine fibroids. Factors that increase a woman’s risk of developing fibroids include:

Factors that lower risk of fibroids:

Diagnosis of Uterine Fibroids

Unless you have symptoms, you probably won’t know that you have uterine fibroids.

Sometimes, health care providers find fibroids during a routine gynecological exam. During this exam, the health care provider checks the size of your uterus by putting two fingers of one hand into the vagina while using the other hand to press lightly on your abdomen. If you have fibroids, your uterus may feel larger than normal or it may feel irregularly shaped. But even small fibroids in the uterus may cause considerable symptoms and heavy periods leading to anemia. Smaller fibroids which can’t be found through a routine manual examination can be detected with ultrasound.

If your health care provider thinks you have fibroids, he or she may use one or more types of imaging technology—machines that create a picture of the inside of your body—to confirm the diagnosis.

Some common types of imaging technology are:

Treatment for uterine fibroids

There are medical treatments for uterine fibroids and surgical treatments for uterine fibroids. 

Your health care provider will consider a number of things before recommending treatment for your fibroids, including:

If you have uterine fibroids but have no symptoms or problems, you may not need treatment. Each year, your health care provider will check the fibroids at your routine gynecological exam to see if they have grown. If you are close to menopause, your health care provider may find that your fibroids are shrinking, which is common during and after menopause.

Medical Treatments for Fibroids

Your health care provider may suggest medical treatments to reduce the symptoms of fibroids or to stop the growth of fibroids. These treatments are less invasive than surgery. However, if the medical treatments are not helpful, then surgery is often recommended. Certain medical treatments to reduce fibroid size and blood loss may be used to help the surgery succeed.

Common medical treatments for fibroids include:

Medical treatments may give only temporary relief from the symptoms of fibroids. Once you stop the treatment, fibroids often grow back and symptoms return.

Medications are generally safe, but they can have side effects, some of which may be serious. Be sure to talk to your health care provider about the possible side effects of any medical treatment you consider.

Surgical Treatments for Fibroids

If you have moderate or severe symptoms of fibroids, surgery may be the best treatment for you.

Surgery can be a major procedure or a minor one. The type of surgery depends on the size, location, and number of fibroids present, and your desire to bear children in the future. Sometimes, there are a variety of surgical options to choose from. Talk to your health care provider about the different types of surgical treatments and about the possible risks, side effects, and recovery time of each procedure.

The current surgical treatments for fibroids are listed below. 

Pregnancy and Uterine Fibroids

If you have fibroids, you may still be able to get pregnant. Many women who have fibroids get pregnant naturally. Advances in treatments for fibroids and for infertility have greatly improved the chances for a woman to conceive. If you have fibroids and wish to become pregnant, it is wise to consult with a knowledgeable provider about the location of the fibroids and possible related problems with establishment or growth of a baby in the womb.

However, some women with fibroids do have trouble getting pregnant. Current research suggests that submucosal and intramural fibroids—fibroids that change the shape and size of the uterine cavity—seem to affect a woman's ability to get pregnant, even with in vitro fertilization. These fibroids may reduce fertility by as much as 70%. However, if the fibroid is treated, fertility may be restored.

Fibroids can also cause pregnancy complications, such as miscarriage, preterm delivery, abnormal position of the fetus, and the need for cesarean (C-section or surgical) delivery. Fibroids can also increase the risk of heavy bleeding after delivery.


Reference: National Institutes of Child Health and Human Development